BACKGROUND: Functional constipation (FC) is a common condition that includes difficult, irregular bowel movements, abdominal pain, and bloating. PURPOSE: To investigate the comparative effectiveness of connective tissue manipulation (CTM) and interferential currents (IFCs) over behavioral education and therapy (BET) on FC. METHODS: Fifty-four patients with FC were randomly assigned into four groups. The control group received only BET, the intervention groups received CTM, IFC0-100, or IFC100 additional to the BET, 3 days/week for 4 weeks. CTM was initially applied to the lumbosacral area; in subsequent sessions, the lower thoracic, scapular, interscapular, and cervical regions were also included, respectively. Bowel function (7-day-bowel diary), constipation severity (Constipation Severity Instrument), and QoL (Patient Assessment of Constipation Quality of Life) were assessed at baseline, after interventions, and at the end of the 1-month follow-up. Treatment satisfaction was assessed with visual analog scales. RESULTS: The defecation frequency increased and the defecation duration per attempt decreased in all groups (p < 0.005). In the CTM, IFC0-100 and IFC100 groups, defecation frequency increased more than in the control group (u 23.500, u 26.500, u 15.500, respectively), (p < 0.0001). The constipation severity decreased (p < 0.005), and this effect was maintained in all groups at the follow-up period (p > 0.05). QoL improved in all groups after the interventions, and was higher in the IFC0-100 (95% CI -15.91 to -2.09), and IFC100 (95% CI -13.99 to -0.17), (p < 0.005) groups than control group at follow-up, with no significant difference between control and CTM groups (p > 0.05). Treatment satisfaction was significantly higher in CTM (95% CI -1.3557 to -0.3443), IFC0-100 (95% CI -1.6911 to -0.6605), and IFC100 (95% CI -1.5450 to -0.5144) groups than control group. CONCLUSION: Additional CTM or IFCs to BET provide significant and long-lasting (at least 1 month) contributions to the bowel functions, QoL, and increase treatment satisfaction in patients with FC.

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